Category: Nursing

Introduction

In the article, Nursing education challenges and solutions in Sub-Saharan Africa: an integrative review, the authors sought to investigate the challenges of nursing education in sub-Saharan Africa and the solutions for improving nursing education. The authors note that the sub-Saharan region continuously reports an increased burden of communicable diseases and HIV/AIDS due to inadequate healthcare workers (Bvumbwe and Mtshali 2). This article confirms that the problem mentioned exists because of poor nursing education system which is not adaptive to the changing healthcare needs, resulting in skill mismatch, poor health services, and understaffing of medical centers.

Research Methods

The authors thoroughly searched information on Google Scholar, PubMed, and Medline on EBSCOhost. They used keywords that included challenges, nursing education, and Africa. All informational sources used in this research were published between 2012 and 2016 and helped in exploring reports regarding challenges and nursing education in sub-Saharan Africa (Bvumbwe and Mitshali 2). Dvumbwe and Mtshali ascertained the relevance of the sources used in this research after studying their titles and abstracts (Bvumbwe and Mitshali 2). As a result, the findings in this article qualify for use in the development of other research articles by other researchers.

Statistical Data Analysis

Thematic analysis was used by the authors to appraise the data they found in the research sources. Additionally, the authors extracted the research data and coded it into a useful framework (Bvumbwe and Mitshali 3). This coded data was then assembled into specific subgroups after being converted from the displayed individual sources. Further, Duvumbwe and Mitshali conducted a thorough comparison of each item to ensure the grouping together of similar data. After comparing and grouping data, the authors embarked on establishing distinct patterns, relationships, themes, and variations to enable them to draw insightful conclusions. Both Duvumbwe and Mtshali, appraised the articles independently to enhance the reliability of their research (Duvumbwe and Mitshali 3). Therefore, other researchers can use the findings of this article in developing the literature review of their work.

Results and Discussion

The researchers conducted an information search from several credible secondary sources. As result, the authors searched data from 1434 sources on various online sites (Bvumbwe and Mitshali 3). Out of these, 1287 sources were from the EBSCOhost database, and 58 and 84 records were from PubMed and Google Scholar, respectively (Bvumbwe and Mitshali 3). In addition, the authors also used five grey sources from experts. However, out of the 1434 sources, abstracts from 1380 studies were not useful to this study because they contained general information about healthcare professional education or nursing education unrelated to Sub-Saharan Africa (Bvumbwe, and Mitshali 3). In addition, the authors also excluded 29 sources because they did not address either solutions or challenges of nursing education (Bvumbwe, and Mitshali 4). Lastly, the researchers found five grey materials and 20 relevant records to include in developing their article (Bvumbwe, and Mitshali 3). As a result, themes such as capacity building, professional regulation, infrastructure and resources, curriculum reforms, transformative strategies of teaching, and collaboration and partnership emerged (Bvumbwe, and Mitshali 4). Findings from the above sources confirmed that nursing education challenges and solutions were similar in the Sub-Saharan African countries thus requiring common solutions.

Conclusion, Recommendations and Relevance

This article concluded that most Sub-Saharan African countries had similar problems and solutions regarding nursing education which included overpopulated institutions, poor capacity building in faculties, and limited infrastructure and resources. As a result, research findings concluded that there is a need for partners to solve nursing education problems in Sub-Saharan countries by increasing faculty capacity, improving curriculum responsiveness, promoting strong regulatory frameworks, and ensuring infrastructure and resource availability. This review is relevant because it adds to the existing knowledge on how stakeholders should solve the current challenges facing nursing education within the sub-Saharan countries.

Work Cited

Bvumbwe, Thokozani, and Ntombifikile Mtshali. Nursing Education Challenges and Solutions in Sub Saharan Africa: An Integrative Review. BMC Nursing, vol. 17, no. 1, 2018, pp. 111.

Differences between CPAP and BiPAP

CPAP (continuous positive airway pressure) is a form of treatment used to deal with patients suffering from breathing problems when they are asleep (sleep apnea). CPAP machines take positive pressure and then apply it inside the patients throat so as to prevent them from developing breathing complications when they are asleep. The airway pressure is usually delivered through an oxygen mask so as to maintain airway patency during sleep. This type of ventilation is mostly used for individuals suffering from acute respiratory failure (type one or two) and breathing problems when they are asleep. Patients who have been put under CPAP ventilation are usually monitored in the intensive care units, high dependency units and specialist respiratory units (Cosentini et al, 2010).

CPAP machines are commonly used to help patients with sleep apnea by delivering a stream of compressed air through the use of a nose mask, full-face mask and nasal pillow. Sleep apnea causes the upper airways of patients to become narrow as the patient is asleep which in turn reduces the oxygen levels in the blood. This reduction in oxygen causes arousal or sleep disturbance making it difficult for the patient to sleep properly. The CPAP machine keeps the airway open under air pressure to ensure that unobstructed breathing is possible therefore reducing the incidence of sleep apnea. The CPAP machine blows air at a prescribed pressure also known as titrated pressure which is air measured in centimetres of water (cm/H₂O) at which most sleep apneas and hypopneas are therapeutically prevented (Tsuda et al, 2010).

BiPAP (Bi-level positive airway pressure) is another type of ventilation device that is used to deliver two types of pressure to patients who have breathing complications as a result of respiratory failure, strokes or heart attacks. BiPAP is considered to be an advancement of the CPAP ventilation technique since it provides more positive airway pressure at the end of inhalation and exhalation. BiPAP allows the setting of two different pressures to support the breathing activities of the patient and these pressures can be adjusted and set at separate rates (Kaplow & Hardin, 2007).

One of these pressures known as the inspiratory positive airway pressure (IPAP) is usually set as a high pressure to support the inhalation functions of the patient. The second type of BiPAP pressure known as the lower expiratory positive airway pressure (EPAP) is usually set at a low pressure to support the patient as they breathe out. The net effect of using the BiPAP machine is increased delivery of air into the patients lungs which means they will have less work trying to breathe. The pressure for the BiPAP machine is set at 5 to 10 cm H₂O titrated pressure to ensure that there is airflow in the patients lungs (Kaplow & Hardin, 2007)

There are various modes or approaches that are used to supply titrated pressure to the patients lungs and they include the spontaneous mode, the timed mode and the spontaneous/timed mode. The spontaneous mode triggers spontaneously the inspiratory positive airway pressure (IPAP) in the device that is being used to deliver the titrated pressure which in turn converts it into the positive airway pressure (EPAP). The second mode used for the BiPAP is the timed mode where the IPAP and EPAP cycling is triggered by a machine at a set rate which is usually expressed in breaths per minute (BPM). The spontaneous/timed mode device triggers IPAP on patient inspiratory effort and there also exists a backup rate that is set to ensure that patients still receive a minimum number of breaths per minute in the event they fail to breath spontaneously (Rueda, 2009).

One difference between the CPAP and BiPAP ventilation devices is that the CPAP delivers a single predetermined amount of pressure while BiPAP has two forms of titrated pressure to help the patient breath. As mentioned earlier a prescribed pressure known as the titrated pressure is usually given to patients under the continued positive airway pressure (CPAP) while the BiPAP pressure devices utilize two levels of pressure known as the inspiratory positive airway pressure (IPAP) and the lower expiratory positive airway pressure (EPAP). The devices that are used in helping patients to breathe in the CPAP technique apply a continuous pressure to the patients airways while the Bi-level positive airway pressure (BiPAP) devices exert high pressure when patients breathe in and deliver low pressure when they breathe out. This basically means that BiPAP devices lower the pressure of air that has been breathed out and they increase pressure in the air when the patient breathers in. This increase and reduction in pressure is not possible in the CPAP ventilation devices aimed at reducing cases of apneas and hypopneas (Cooper et al, 2006).

The CPAP devices also differ from BiPAP in that patients using the machines have to use a lot of force when exhaling to work their lungs against the extra pressure. This is mostly attributed to the single level of pressure that is used by CPAP devices to help patients during respiratory exercises. This proves to be a tiring exercise for the patients especially those that are suffering from neuromuscular diseases. The BiPAP devices on the other hand are able to adjust air pressure which means that they easy to handle and they can be adapted to suit the breathing needs of patients. The dual pressure adjustments that come with the machines help patients to get more air in and out of their lungs without much effort (Collen, 2009).

Arterial Cannulation

Arterial cannulation is a procedure that is commonly performed in the healthcare management of patients who are critically ill. The procedure involves the use of arterial catheters to allow for the continuous monitoring of the patients blood pressure. These procedures are usually used for patients who are suffering from heart disease, coronary artery disorders and other heart disorders that affect the proper flow of blood. Arterial catheters have been considered to be relatively safe with a low incidence of serious complications to the patients who use this mode of treatment. The main arteries that are used for cannulation or catheterization include the radial arteries, ulnar, brachial, femoral and axillary arteries with the radial artery being the most commonly used artery for cannulation amongst children and adults (Barash et al, 2009).

The radial artery is common because of the superficial nature of the vessel and the ease of maintaining the site of the artery as well as the arteries accessibility and presence of a collateral supply of blood. Multiple arteries can be used for the direct measurement of blood pressure where an Allen test is performed by compressing both the radial and ulnar arteries of the patient. The Allen test can be used to identify the potential sites for arterial catheterization since it requires the patient to tighten their fists as they compress both the radial and ulnar arteries of the patient. The release of pressure on each artery determines the dominant vessel that is used to supply blood to the patients hand. This vessel is then used for the arterial cannulation as long as the patient responds positively to the Allen test (Barash et al, 2009).

Many cannulation sites have been used for the direct arterial blood pressure monitoring of patients with heart problems. A necessary condition which is needed before any arterial cannulation techniques are conducted is the identification of the arterial pulse on the patient which is usually enhanced by using the Doppler flow detection device. Other techniques that can be used in the identification of potential sites for arterial cannulation include the transfixion-withdrawal method, the direct arterial puncture method and the guide wire-assisted cannulation technique which is also referred to as the Seldinger approach. Identification of potential sites for arterial cannulation is an important activity as it helps to determine the arterial pulse of the patient and whether they can be able to withstand the cannulation procedure which is usually invasive in nature (Yavuz, 2008).

The post insertion management of the arterial catheter involves activities that are directed towards managing the potential complications which might arise when a catheter is introduced into the patients body. Arterial catheters in general are associated with a variety of complications some of which include the infection of the patients blood stream, damage to the arteries during the insertion of the catheter, reduction of blood flow to the various tissues in the insertion site and hemorrhaging as a result of a ruptured artery (ICCMU, 2007).

For post insertion management activities to be conducted effectively, the type of dressing used to put in place the arterial catheter should be transparent and occlusive. This will enable the health care workers responsible for the arterial cannulation to assess the arterial catheter site for any infections and also ensure that the catheter is safe and secure. The catheters also need to be checked at an hourly basis after they have been inserted to ensure that they are performing their intended purpose. Checking the catheters hourly also ensures that there is no room for infections or other harmful bacteria to grow in the cannulation site. Infections can be prevented through the use of closed pressure transducer sets where it is possible for the patient to develop an iatrogenic anaemia or clinician infection. There also needs to be a frequent assessment of the insertion site so that any movement of the catheter can be easily detected (ICCMU, 2007).

The most common technique that is used to detect the normal waveform of the patient is the Allen test which seeks to evaluate the collateral circulation of blood to the hand via the ulnar artery. The hand is usually elevated and made into a fist for 30 seconds to allow for simultaneous pressure to the ulnar and radial arteries of the patient. The patient is then told to open their fist and if colour returns to the hand in five seconds, the Allen test is negative meaning that the radial artery can be cannulated. If on the other hand colour does not return to the hand within five seconds, the Allen test is positive or abnormal meaning that the patients blood supply to the hand is insufficient to support an arterial cannulation procedure (Asif & Sarkar, 2007).

Extra Ventricular Monitoring

Extra or external ventricular monitoring and drainage systems are those that are used to monitor and drain cerebrospinal fluid from the brain and spinal cord of a person recorded to have a high intracranial pressure. Extra ventricular monitoring and drainage activities are the standard health care activities that are used to temporarily control intracranial pressure by draining the cerebrospinal fluid externally from a patients body (Cartwright & Wallace, 2007). EVDs and intracranial pressure (ICP) monitors are the most commonly used tools in the neurological management of patients suffering from brain tumours and other neurological disorders. Apart from draining the infected cerebrospinal fluid (CSF), extra ventricular drainage systems are also used in neuro critical care situations such as those that relieve elevated intracranial pressure (ICP), those that drain bloody CSF or blood haemorrhaging and those that monitor the flow rate of cerebrospinal fluid (Ehtisham et al, 2009).

The role of extra ventricular monitoring and drainage as a therapeutic intervention to the management of intracranial pressure is to lower this pressure through the employment of intermittent techniques that will continuously drain the cerebrospinal fluid from the brain and spinal cord of the patient. EVDs also facilitate the measuring of the intracranial pressure of the patient on a temporary basis after the patient has been prescribed with intrathecal medication. The equipment that is used to monitor and drain CSF from the patients brain and spinal cord includes an EVD with pressure tubing that is connected to a monitor and drainage system, a measuring tape that has been marked in centimetres and a carpenters spirit level. A doctors order is also needed for the CSF drainage to take place where the doctor prescribes the level of ICP that will be used to initiate the drainage (AACCN, 2009).

Monitoring and draining the intracranial pressure of an individual is an important activity because the build up of this type of pressure leads to the distortion and dysfunction of a persons brain nerve pathways. In severe cases the build up of intracranial pressure in the brain and spinal cord of an individual leads to herniation which is the pathological displacement of brain tissue. If the ICP level is close to the mean arterial blood pressure of an individual, it might lead to an impairment of cerebral blood flow of the patient which leads to brain dead cells and the eventual death of the patient (Dixon, 2009).

The monitoring and drainage of CSF is therefore an important activity as it reduces the probability of brain swelling, intracranial mass lesions or obstructions in the brain and spine that complicate the movement of cerebrospinal fluid. EVD systems are used for the therapeutic drainage and monitoring of CSF thereby reducing the build up of intracranial pressure (Dixon, 2009). While they are important in alleviating brain problems, EVD systems give rise to complications such as brain infections, brain leaks as a result of the incorrect height of the drainage burette and the inaccurate monitoring of intracranial pressure (AACCN, 2009).

Therapeutic Hypothermia

Therapeutic hypothermia is a form of medical treatment used to treat patients who have suffered from ischemic injuries such as brain injuries, strokes, spinal cord injuries and neurogenic fever as a result of poor blood flow by lowering their body temperature. Therapeutic hypothermia can be administered through invasive procedures such as the femoral catheter which is used to regulate the patients body temperature and the non-invasive procedures such as chilled water blankets and leg wraps that have been put in direct contact of the patient. It is usually recommended to initiate therapeutic hypothermia treatments as soon as individuals or patients suffer from possible ischemic injuries because time moderates the effectiveness of hypothermia as a neuroprotectant (Jess et al, 2009).

Past research has revealed that hypothermia possesses neuroprotective qualities that decrease cerebral oxygen when a patient is suffering from an ischemic injury. Recent studies have been able to reveal that prolonged moderate hypothermia at 32 to 33 degrees Celsius that has been maintained for a period of between 12 to 24 hours in a comatose patient usually leads to an improvement in the neurological outcome of the patient. These studies were also able to reveal that the patients experienced a reduction in their neurological injuries which were cooled down by the therapeutic hypothermia. This reduction was mostly attributed to a decrease in the free radicals that were normally generated after reperfusion. These radicals usually overwhelmed the enzymatic and non-enzymatic neuronal protective mechanisms of the body leading to the destruction of neural pathways in the brain (Birch, 2005).

The introduction of moderate therapeutic hypothermia after patients have suffered from ischemic injuries has been successfully used since the 1950s. This mode of treatment showed improved neurological recovery in patients that had suffered heart attacks, strokes, cardiac arrests and other forms of ischemic injuries. Therapeutic hypothermia was able to reduce injuries to the neural networks of patients caused by oxidative stress resulting from the restoration of blood supply to respond to the ischemic injuries. Hypothermia that was therapeutically managed was also able to moderate the intracranial pressure in the brain or spinal cord of an individual thereby minimizing the harmful effects of a persons immune inflammatory system during periods of reperfusion (Birch, 2005).

The techniques that are used to conduct therapeutic hypothermia include invasive and non-invasive techniques. Cooling catheters which are a type of invasive technique are usually inserted in the femoral vein of an individual and a cooled saline solution is then circulated within the patients body lowering their temperature. The non-invasive techniques require the use of water blankets or leg wraps that have been placed in direct contact with the patients skin so that they can lower their body temperature to the appropriate level. These non-invasive techniques lower the body temperatures of ischemic injury patients where 70 percent of their bodies are covered with these treatments (Hinz, 2007).

Principles of Cardiac Defibrillation

Cardiac defibrillation is a common treatment that is used in life threatening situations that include cardiac arrhythmias and pulse-less ventricular veins where the patient fails to record a pulse in their major blood arteries. Patients who suffer from heart failure or severe strokes are usually at a high risk of sudden cardiac death due to heart failure progression. Cardiac defibrillation involves delivering an electrical charge to the affected patient so as to initiate the patients cardiac functions in the event of cardiac arrest. This device usually depolarizes the critical mass of the patients heart muscle thereby terminating a case of cardiac arrhythmiasis. This in turn caters for a normal sinus rhythm that is sustained by the bodys natural pacemaker ensuring the flow of blood in the heart. Defibrillators are external devices but they can be implanted in a patient depending on the type of device that is used for the cardiac defibrillation exercise (Trayanova, 2006).

The principle of cardiac defibrillation is mostly dependent on the position of electrodes used to depolarize the critical mass of the heart muscles. These electrodes are usually delivered by a variety of components that make up the cardiac defibrillators and one of these components is the capacitor. A capacitor is made up of a pair of conductors that are used to deliver electrodes to the heart. These conductors lose and gain electrons quickly thereby maintaining a continuous flow of electric currents that are charged to deliver electrodes. The electrodes are able to store and deliver a large amount of energy stored as electrical charges to the patient initiating their cardiac functions (Trayanova, 2006).

Inductors are also important components of cardiac defibrillators because they successfully deliver the current to the heart by prolonging the duration of current flow. They can accomplish this because of their ability to produce a magnetic field that will allow the flow of electrical charges to facilitate the shocking of the patient. As soon as the current passes through the inductor, it generates a flow of electricity in the opposite direction of the charges which is used to oppose the current flow (Hayes & Friedman, 2008). The two types of defibrillators that are commonly used in the therapeutic shock of patients who have suffered ischemic injuries include the monophasic and biphasic defibrillators. The biphasic defibrillators were introduced recently into the medical market but before then the monophasic defibrillators were commonly used to depolarize the patients heart muscles. The advances in technology saw the biphasic defibrillators being developed to meet the treatment needs of life threatening disorders such as cardiac arrhythmias (Paradis et al, 2007).

Monophasic defibrillators differ from the biphasic defibrillators in that they deliver the current flow in one direction while the biphasic defibrillators deliver the current in two directions which means that they have a higher efficacy rate compared to the monophasic defibrillators. In the monophasic defibrillator, the current moves from one paddle to another while in the biphasic unit the flow moves in two directions which are from one metal paddle to another and then again in reverse to initiate the flow of the electrical current. The multiple direction of the current flow supported by the biphasic defibrillators has been able to lower the threshold for successful defibrillation thereby saving more lives when compared to the monophasic defibrillators (Paradis et al, 2007).

Research work that has been conducted on the efficacy of the two defibrillators has been able to reveal that the biphasic unit has a higher efficacy rate when compared to the monophasic defibrillator. This can mostly be attributed to the 90 percent shock rate that the biphasic defibrillators possess in reviving patients against the 75 percent shock rate of the monophasic defibrillator. In defibrillation dosing, the defibrillator units need to deliver an appropriate amount of electrical shock to ensure that the heart is charged at an appropriate current. In the monophasic units, the delivery of the treatment dosage usually takes a great deal of time when compared to the biphasic units. Less energy is also needed to deliver the current flows to the patients chest for the biphasic unit which is not the case for the monophasic units that require more energy to apply the currents (Gregory & Mursell, 2010).

A waveform for a defibrillator is important because it delivers the changing patterns of the current when a patient is being shocked. The waveforms between the two defibrillators are different in that the biphasic units are able to adjust the waveforms to ensure that the current flow is able to move through the heart thereby resuscitating the patient. The American Heart Association considers the biphasic units to be the safer and effective alternative to cardiac support treatments because they provide efficient and personalized waveforms used to revive cardiac arrest patients (Gregory & Mursell, 2010).

The clinical application of cardiac defibrillation involves placing a metal paddle with an insulated plastic handle on the patients skin after the application of a gel. The purpose of the gel is to reduce the electrical resistance that will be caused by the flow of electrical charges on the patients body. The paddles which are also known as resuscitation paddles are usually placed on the patient according to two schemes one of which is the anterior-posterior scheme. This scheme involves placing one resuscitation electrode over the lower part of the patients chest and placing the other behind the heart. The second scheme referred to as the anterior-apex scheme places anterior electrodes in the right side of the patients body while the apex electrode is usually positioned on the left side of the body. The application of these schemes requires health workers such as nurses to consider the severity of the patients cardiac arrhythmias so as to determine the amount of current flow that will be applied to the patients chest (Hayes & Friedman, 2008).

References

AACCN (2009). Monitoring technologies in critically ill neuroscience patients. London, UK: Jones and Bartlett Publishers

Asif, M., & Sarkar, P.K., (2007). Three-digit Allens test. The Annals of Thoracic Surgery. 84(2): 686-687

Barash, P.G., Cullen, B.F., Stoelting, R.K., & Cahalan, M., (2009). Clinical anesthesia. Philadelphia: Lippincott Williams and Wilkins.

Cartwright, C.C., & Wallace, D.C., (2007). Nursing care of the pediatric neurosurgery patient. Berlin, Germany: Springer Verlag

Collen, J., (2009). Clinical and polysomnographic predictors of short-term continuous positive airway pressure compliance. Chest, 135: 704-709

Cooper, N., Forrest, K., & Cramp, P., (2006). Essential guide to acute care. Oxford: Blackwell Publishing

Cosentini, R., Brambilla, A.M., & Aliberti, S., (2010). Helmet continuous positive airway pressure vs oxygen therapy to improve oxygenation in community-acquired pneumonia: a randomized, controlled trial. Chest, 138(1): 114-120

Dixon, M., (2009). Nursing the highly dependent child or infant: a manual of care. Oxford, UK: Blackwell Publishing Limited

Ehtisham, A., Taylor, S., Bayless, L., Klein, M.W., & Janzen, J.M., (2009). Placement of external ventricular drains and intracranial pressure monitors by neurointensivists. Neurocritical Care, 10(2):241-247

Gregory, P., & Mursell, I., (2010). Manual of clinical paramedic procedures. Oxford, UK: Blackwell Publishers

Hayes, D.L., & Friedman, P.A., (2008). Cardiac pacing, defibrillation and resynchronization: a clinical approach. New Jersey: John Wiley and Sons

Hinz, J., (2007). Effectiveness of an intravascular cooling method compared with a conventional cooling technique in neurologic patients. Journal of Neurosurgical Anesthesiology, 19(2).

ICCMU (2007). Nursing management of arterial catheters for critically ill patients: arterial guideline development network. New South Wales, Australia: Intensive Care Coordination and Monitoring Unit.

Jess, B.S., & Harrison, E.E., (2009). Review article of the use of early hypothermia in the treatment of traumatic brain injuries. JSOM Summer, 10(1): 10

Kaplow, R., & Hardin, S.R., (2007). Critical care nursing: synergy for optimal outcomes. New Jersey: Jones and Bartlett Learning

Paradis, N.A., Halperin, H.R., & Kern, K., (2007). Cardiac arrest; the science and practice of resuscitation medicine. Cambridge, UK: Cambridge University Press

Rueda, A.D., (2009). Improving CPAP compliance by a basic educational program with nurse support for obstructive sleep apnea syndrome patients. Sleep Science, 2(1):8-13

Trayanova, N., (2006). Defibrillation of the heart: insights into mechanism from modelling studies. Experimental Physiology, 91(2): 323-337

Tsuda, H., Almeida, F.R., Tsuda, T., Moritsuchi, Y., & Lowe, A.A., (2010). Craniofacial changes after 2 years of nasal continuous positive airway pressure use in patients with obstructive sleep apnea. Chest, 138(4):870-874

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Introduction

Throughout its history, nursing has turned out to be an important discipline, especially in care-giving scenarios. Like other professional disciplines, nursing mainly focuses on human health and several approaches of healing through caring. In general, the science of nursing encompasses models, theories and research findings, which are specific to the discipline (Cara, 2003). As a result, it has been argued that nursing needs theory-guided models in order to address emerging issues in the 21^st century.

This has also been necessitated by the diverse nature of nursing environments, which call for variation in the care-giving process. In some cases, nurses are forced to shift the approach to identify with patients or the communities being served. Similarly, interdisciplinary practice has widely been advocated for the purpose of incorporating other disciplines in the process of caring patients (Watson, 2009). This research paper focuses on Jean Watson theory, by synthesizing various aspects, including but not limited to the development of the theory, how nursing is conceptualized in the theory and its application in nursing practice.

Jean Watson Theory

The practice of nursing is characterized by several theorists, who have devoted their time and resources in exploring different models of caring and healing. One of these is Jean Watson, whose contribution to the discipline is invaluable. She was born in 1940, in West Virginia in the United States (Parker & Smith, 2010). As a professor of nursing, Watson has immensely contributed to the practice, through research work, authoring of books and journal articles and establishment of foundations to advance the practice of nursing.

Overview of Jean Watson Theory

Watson developed the theory of human caring between 1975 and 1979, while she was lecturing at the University of Colorado. According to Watson, the instinct to develop the theory emanated from her personal views towards nursing, coupled with several studies she had undertaken in various disciplines, including psychology, clinical and education (Parker & Smith, 2010). The theory was her personal efforts to redefine nursing by giving it a new meaning as a new discipline, which was emerging, with unique values, mission, knowledge and practices.

Additionally, this contribution was further influenced by a comprehensive nursing curriculum, together with the passion of developing meaning to the entire nursing discipline, which would cut across populations, settings, specialty and subspecialty sections. From this, Watson was able to make it clear that nursing practices were aimed at subjective healing approaches and the entire life of the person going through the experience (Parker & Smith, 2010). As a result, this approach called for unique healing frameworks and healing arts in order to address the existing problem. Watson referred to this frame work as carative factors, even though it contrasted curative factors, which had been known throughout the healing process. This philosophy further aimed at creating a balance for the field of medicine, by giving nursing its unique professional and scientific standing.

Importantly, Jean Watson described the theory using several conceptual elements, which included: ten carative factors, transpersonal relationship, caring modalities and caring moment. Moreover, several aspects of the theory have continued to emerge since Watson gave conceptual position of the philosophy (Parker & Smith, 2010). For instance, the views of self and person have been expanded to include transpersonal mind. Others are unitary consciousness and advanced healing modalities. The following segment of the research paper describes how the theory of Jean Watson is conceptualized in nursing.

Ten Carative Factors

Watsons original theory was divided into carative factors to shape the progress of nursing practice. Although the pillars are still known as factors, the term has been replaced with clinical caritas, which offers a more elaborate structure that addresses the evolving nature of the discipline in the contemporary society. In general, caritas connotes something, which is precious and fine (Watson, 2009). The two words, carative and caritas are closely related and can be compared for the purpose of invoking love. It therefore allows love and care to be assimilated into a more elaborate form of transpersonal caring. The advantage for this approach is that it allows inner healing for ones self and others, which is equally extended to the entire universe. It suffices to mention that the emerging model being applied in nursing is shifting from carative to caritas to create a link between past and the future by use of predictable methods. Watson acknowledged that the future of nursing was broadly depicted by Nightingales understanding of caring, which is founded on commitment to human ethics in serving various people in the society (Watson, 2009).

According to Watson, caring and love have to be included in the work of a nurse in order to appreciate the fact that nursing goes beyond ones job description; it offers life-giving and life-taking opportunities. This allows one to continuously learn and grow in various aspects of nursing practice. Importantly, for the inclusion of the past and the future to be effective, it requires the transformation of institutions, those being served and the entire profession of nursing (Watson, 2009). In this regard, it is important for one to acknowledge the essence of life. The model makes use of art and science and acknowledges their fusion with spirituality. There are several changes in the transpersonal caring, which require nurses to find out what and how the theory communicates to them.

Original Carative Factors of Jean Watson

These actors are believed to have served a significant role in giving direction to what was referred to as core nursing as opposed to nursings trim. They mainly address major nursing aspects, which play a fundamental role in therapeutic healing processes (Watson, 2009). In other words, they affect both the nurse and the person being nursed. In other words, the core of nursing could be described as an art, philosophy and science of healing. Notably, carative approach of nursing has the ability to go beyond the trim of changing times, settings, treatment and technology among others. From this point of view, it is important to underscore the fact that defining nursing on the basis of this concept remains cumbersome.

Equally, nursing trim cannot be used to explain nursings role and mission in the society. This creates the need for a nursing theory together with transpersonal theory, which is crucial in complimenting modern nursing. The ten carative factors, which were included in Watsons theory, were: the establishment of a humanistic system, instillation of faith, nurturing sensitivity to others, development of a trustworthy relationship, approval and acceptance of others, promotion to transpersonal teaching, provision of a holistic and healthy environment, support for human needs, and acceptance of spiritual forces (Watson, 2009). Even though some of the factors mentioned above are sill applied in nursing practice through theory-guided models, Watson noted that there was need of transforming these factors into clinical caritas processes.

Carative factors to Clinical Caritas Processes

It is evident that there has been significant evolution in nursing practice, leading to the emergence of new models of caring and promoting healing in hospitals. Due to this shift, the initial ten carative factors have been transposed into caritas processes, which are more simplified for consideration (Watson, 2009). This is to say that each of the above factors has been adjusted to address the needs within the ever-evolving nursing environment. Firstly, the formation of a humanistic system of professional values is being manifested through love, kindness, equanimity and calmness as applied in caring unconsciousness. Secondly, the concept of instilling hope and faith translates into being authentically present and supportive. On the other hand, nurturing of ones sensitivity towards self and others changes into cultivation of individual spiritual life practices and transpersonal self. This ensures that one operates beyond ego and opens to others with compassion (Cara, 2003). In addition, establishment of trustworthy relationships has been turned into development and sustenance of a helping-trusting relationship.

Similarly, the model appreciates the need for personal support instead of mere recognition of feelings to initiate a tie between the nursed and the person being nursed. The discipline has also witnessed the emergence of artistry model of caring-healing process instead of systematic application of a creative problem-solving and caring process. The adoption of genuine teaching-learning experience has been introduced, replacing transpersonal teaching. This ensures that one remains tuned in the frames of reference. Due to these shifts, a holistic caring environment has become a healing environment at all levels of nursing practice. Moreover, gratification of basic needs, as it was defined in carative factors has shifted to assistance with basic needs, with a caring consciousness. This allows the alignment of mind, body and spirit in all aspects of care, given in hospitals. Lastly, the evolution from carative to caritas allows one to respond to spiritual needs of an individual (Suliman, Welmann, Omer & Thomas, 2009). In other words, it allows taking care of ones soul together with the person being taken care of.

Unlike in the original carative model, clinical caritas encompasses the fusion of a spiritual dimension and a caring paradigm that has love. According to Watson, this perspective supports the existence of a relationship between the model and Nightingales approach to nursing. Although this direction is coined theoretically, it goes beyond the theoretical aspect of nursing and offers a converging model for the future of the discipline. For this reason, Watson considers her work to be more ethical, philosophical and a blueprint for the evolving nature of nursing, rather than a skeleton of a theory (Suliman, Welmann, Omer & Thomas, 2009). Nevertheless, there are people who have found the model to be slightly demanding and have had to interact with it at its level of abstractness. Notably, Jean Watson theory has continuously been used in clinical practice models, educational curricula, and research methods.

Implications of Jean Watson Theory

Based on the components of the theory, developed by Jean Watson in 1979, it is evident that the model has had a significant impact in nursing as a discipline and to nursing professionals. Essentially, the model can be used as an ethical and philosophical foundation, for nursing practice and forms the epicenter of the profession at a disciplinary level. Unlike other designs, Watsons model can be applied both as an art and a science, giving it an advantage interdisciplinary caring, which is important in modern nursing challenges (Watson, 1999).

Besides this, the model also allows new dimensions for medicine, which deals with the mind, body and spirit. Its simplicity further allows individuals to read, learn, study and research the theory. However, a true understanding of the theory occurs when a person experiences it from a personal level. It therefore presents an opportunity to interact with the ideas in various ways, in ones personal or professional life. In addition, ones commitment to caring consciousness is necessary in confronting various challenges experienced in nursing as a discipline (Watson, 1999).

Application of Jean Watson Theory

A nurse can use this theory to advance the science and or practice of nursing in various ways. Jean Watsons theory can help a nurse to deal with several complexities, which arise while dealing with various nursing situations. For instance, a nurse who is taking care of a patient, awaiting a second amputation can apply the ten caritas factors to enhance her caring. This would allow the nurse to be attentive, listen to the patient and comfort him or her.

The ideas presented in the theory give a platform for us to asses, critique, and help in locating ourselves within the entire framework of caring. However, its proper application requires one to think along a certain path. For instance, it is important to know if there exists any congruence between values and major concepts presented in the model (Walker & Avant, 2010). From this, one is able to relate the model with the clinical administrative setting, population needs or any other entity, which may be relevant in improving nursing practice. Furthermore, it is crucial for one to understand his or her views of human. What does it mean to be human, healing, caring, transforming and growing? This beckons the question of whether you are a human being with spiritual experience or you are a spiritual being with human experience. Essentially, this mindset shapes the perception of a person towards the world and enhances the identification of ones position in the caring field.

In the application of this model in nursing practice, an understanding of the concept of evolution is paramount. As a result, it would be important to know whether the interest is centered at personal evolution or involves the transformation of other people with care needs. This piece of work has a far-reaching role and impact in nursing practice. Among other things, it aims at clarifying the maturity of nursing and enhancing its intersection with other health sciences. It is worth noting that nursing caring theory-related activities have continuously been developed in the United States and around the world (Walker & Avant, 2010). Importantly, several hospitals have adopted this approach in augmenting caring and healing among patients; the theory is used in Magnet Hospitals in the United States as a guide (Parker & Smith, 2010, p. 359).

Conclusion

From the above research analysis, it is doubtless that Jean Watsons contribution in nursing practice will forever be applauded. Of great significance is the caring theory, which she developed in late 1970s, to transform the entire nursing practice, by promoting the concept of interdisciplinary practice. Her shift from carative factors to clinical caritas was essential in developing a link between modern, poster-modern and traditional nursing practices.

References

Cara, C. (2003). A pragmatic view of Jean Watsons caring theory. International Journal for Human Caring, 7(3), 51-61.

Parker, M., & Smith, M. (2010). Nursing Theories and Nursing Practice. Philadelphia: F. A. Davis Company.

Suliman, W. A., Welmann, E., Omer, T., & Thomas, L. (2009). Applying Watsons Nursing Theory to Assess Patient Perceptions of Being Cared for in a Multicultural Environment. Journal of Nursing Research, 17(4), 293-300.

Walker, L., & Avant, K. (2010). Strategies for Theory Construction in Nursing. New Jersey: Prentice Hall.

Watson, J. (1999). Nursing: Human Science and Human Care: A Theory of Nursing. Massachusetts: Jones & Bartlett Learning.

Watson, J. (2009). Caring Science and Human Caring Theory: Transforming Personal and Professional Practices of Nursing and Health Care. Journal of Health & Human Services Administration, 31(4), 466-482.

Introduction

Individuals can figure out who, what, where, when, why, and how to do nursing by looking at the scope of nursing practice. These things must be discussed to understand professional health care. The who to do nursing is all the nurses worldwide who have finished their training, earned a title, and are legally allowed to work.  When a patient needs care forms a nursing event. Nursing can be used everywhere through direct care, education, and advocacy. How nurses do their jobs is affected by plans, strategies, conventions, and procedures. Based on the social compact, which says that nurses have an ethical duty to society, the why of nursing is to improve public health care and the quality of life for patients (American Nurses Association, 2015). A nurse practitioner who works in long-term care or a registered nurse can specialize in nursing, and how much they do will depend on their education and the communitys needs.

Important Qualities for a Nursing Profession, Sources of Inspiration and Motivation

In line with what motivates people to become nurses, having job stability and advancement opportunities is vital when becoming a nurse. As the population ages, more individuals suffer chronic diseases, and care evolves; therefore, nurses will remain crucial (Walden University, 2018). Compassionate, well-educated nurses may be needed if there is a need for more physicians. To address the inspiration for one to become a nurse, numerous individuals are inspired by nursing because they watch young people struggle with their attitudes, emotions, and feelings. Nurses can assist the individuals mentioned above in becoming autonomous citizens (Macdiarmid et al., 2021). From the question on the most important qualities of a nurse leader, practitioners use effective nursing leadership principles and practices to achieve professional success. A manager or resident nurses principal responsibility is keeping patients healthy. Nurse managers and leaders both lead and advise their teams. Leaders in nursing advocate for their profession, patients, and colleagues so everyone may work honestly and productively. These are the obligations they accept and carry out effectively daily; they promote innovative methods of patient care and mentor other healthcare practitioners.

Greatest Challenges to Nursing and the Nurse Leader

In response to inquiries about the most important issues in the nursing profession and the greatest challenges nurses encounter, the field of nursing has always been demanding, but new difficulties have emerged recently. These days, especially in the last few years with the Covid-19 outbreak, nurses and nurse leaders are expected to offer excellent services with minimal resources. Several issues have always been anticipated, while others result from contemporary healthcare. Typical nursing concerns and why professional nurse leaders are crucial are listed as follows. First, a positive work atmosphere may significantly reduce the stress of a job in medicine. For the sake of teamwork and friendship with other medical professionals, many nurses are willing to put up with long shifts and challenging patients (Nursing, Program Insights, 2022). Consequently, it is easy to understand why many nurses feel burnt out; they have a lot on their plates but often get little assistance. Even with all that enthusiasm, they face so many daily difficulties that it is hard to see how they can succeed. In addition, Burnout is often at the root of nurse retention problems. Finally, as the need for nurses increases, many hospitals are turning to less-qualified candidates who may need more experience or education to provide the kind of care that patients deserve. Inspiring nurse leaders with the aptitude to have an impact may help alleviate the worries mentioned earlier (American Nurses Association, 2015). As leaders in the healthcare industry, nurse managers are crucial in creating a productive and secure workplace for the nurses and other staff members they supervise.

Important Qualities of a Successful Nurse and Issues and Challenges They Face

To begin, the answer to the question of what major challenge nurses face is the problem of patient experiences. The challenges mentioned above make it harder for nurses to provide excellent care. This scarcity forces nurses to provide less than optimal care to their patients, which often leaves patients feeling neglected. Unhappy customers are less likely to return for follow-up treatment, which might affect the final statistic (American Nurses Association, 2015). Staff rounding and open lines of communication are just two examples of how nursing leaders may improve their patients experiences by fostering an environment that values patients and medical professionals health and well-being. Examining the question of what important quality makes a good nurse. A competent nurse should be compassionate toward their patients. As part of their job, nurses frequently see pain and suffering and must show empathy for clients and their loved ones beyond just providing a solution. This paves the way for developing trusting connections between them and their patients. Lastly, individuals ask about the most important issues in the nursing profession today. It is uncommon for businesses to have temporary staffing issues; in many cases, the disruption is minimal. However, when it comes to nursing, having few staff members might mean the difference between living and mortality. Nursing staffing levels have been shown to affect client satisfaction and work engagement positively.

Advice, Future Plans to Nursing Staff, and Handling of Conflict within Nursing Staff

Regarding managing conflicts between nursing staff, one would act quickly after sitting for reflection to resolve any issues that may arise. The best solution is a conversation about the problem when it is fresh in both individuals minds before it causes friction among healthcare partners. Another tactic for dealing with confrontations is to shift the conversations focus from the people involved to the actions at hand. For example, I saw the client sheet was empty when I arrived for my turn, instead of You rarely complete the client sheet accurately, is a more professional way to address a colleague. One can keep the discourse focused on finding solutions instead of assigning criticism if they shift the conversations attention to the actions and concerns at hand. Concerning the plans for the future, nursing staff often say they want to see a shift to a system that prioritizes the needs of patients.

In addition, emphasizing primary care over specialty care, moving treatment out of hospitals and into communities, and streamlining the process for everyone involved is encouraged. Lastly, in addressing what advice will be offered to emerging nurse leaders. A team leader should take the time to teach and educate a struggling team member rather than just assigning someone else to do the job. Maintaining a positive attitude and realizing that helping their co-workers improves patient care. They should also look for small tasks that they can give to others, like those related to their job.

Conclusion

A nurses involvement in resolving health concerns may be understood in several ways, as is reflected in the standards scope of practice. The nursing practice may be supplemented by incorporating alternative service frameworks, such as those emphasizing the nurses capacity to research, teach, and lobby for patients. While the teachers duties and lobbying would be done as interventions, the researchers job is to help with the nursing processs evaluating and diagnosing steps. The scope of this philosophy extends from addressing public legislation and community issues to caring for individuals.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed) Nursebooks.org.

Macdiarmid, R., McClunie-Trust, P., Shannon, K., Winnington, R., E. Donaldson, A., Jarden, R. J., Lamdin-Hunter, R., Merrick, E., Turner, R., & Jones, V. (2021). What Motivates People to Start a Graduate Entry Nursing Programme: An interpretive multi-centered case study. SAGE Open Nursing, 7. Web.

Nursing, Program Insights. (2022). Top issues in nursing  and how nurse leaders can address them. Post University. Web.

Walden University. (2018). 10 Great reasons you became a nurse. Walden University. Web.

Definition of Documentation

There is a wide variety of data related to the treatment process, assessment of the condition of the patient, progress records, plans, and reports. Such data is directly related to the clients well-being and should be appropriately analyzed. In order to conduct an efficient, timely analysis of these valuable databases, a systematic approach should be implemented. Documentation is a systemized material containing the above-mentioned information, which is recorded according to a particular framework. There is a competency-based approach to documentation, which may contribute to the precise and concise recording of valuable patient-related data.

Documentation Competency

Competency 112 implies that documentation should be recorded in relation to treatment goals and objectives. In order to provide appropriate documentation, it is necessary to have sufficient knowledge regarding the process of reviewing and updating records. It is also crucial to know specific clinical terminology and utilize it in documentation in order to achieve treatment goals. Compliance with clinical terminology contributes to the precise interpretation of documentation. It is necessary to have sufficient skills in using standardized abbreviations in order to avoid confusion. The ability to note limitations related to the client and the implemented treatment is significant, as it may help to provide suitable methods and approaches.

Recording changes in the clients status, behavior, and level of functioning are needed to analyze progress and adjust treatment to achieve objectives. Documentation should also be precise to serve its primary purpose properly. Therefore it is essential to have the ability to prepare clear and legible documents. There are also two considerable attitudes, which should be implemented. It is vital to acknowledge the required objectivity and precision in documentation, as it plays a significant role in treatment provision. There may be rapid changes in the clients state, hence documentation should be provided in time.

The evidence-based method that nursing staff is starting to embrace in several settings includes integrating research results into their choices and their engagements with patients. Within a clinical environment, it signifies that nurses are using research to guide their professional practices, improve the quality of care they provide, and better understand their patients needs (Wainwright et al., 2018).

There are several signs at my workplace that nursing is moving toward evidence-based practice. For example, our institutions specialized research program aims to discover and implement the best practices based on the latest data. Furthermore, a range of programs is in place to assist nurses in critically evaluating research and implementing it to steer their profession.

For example, the administration offers research curriculum workshops and a library and information for nurses to use. We have also implemented several quality improvement projects that are on evidence-based practice.

Spirituality and Self-care

Whenever it comes to spirituality and self-care, I believe nurses are extremely valuable in assisting sick people in finding meaning and purpose in their lives. Allowing patients to reflect on the value of life is one method nursing staff can achieve this. Nurses can help patients with their spirituality and self-care by providing information and resources on self-care. Providing patients with these opportunities and tools may include personal details about anxiety, stress, exercise, and nutrition (Straßner et al., 2019).

Nursing Christian Alignment

Simple actions can have a significant impact on patients wellness. The daily task of nursing the sick helps nurses to practice the worldwide Christian religion. Nurses have an important role in preventing and alleviating pain, from obtaining samples from patients and aiding in diagnostics to giving pre and post-spirituality and self-care.

References

Straßner, C., Frick, E., Stotz-Ingenlath, G., Buhlinger-Göpfarth, N., Szecsenyi, J., Krisam, J., Schalhorn, F., Valentini, J., Stolz, R., & Joos, S. (2019). Holistic care program for elderly patients to integrate spiritual needs, social activity, and self-care into disease management in primary care (HoPES3): study protocol for a cluster-randomized trial. Trials, 20(1). Web.

Wainwright, D. W., Oates, B. J., Edwards, H. M., & Childs, S. (2018). Evidence-Based Information Systems: A New Perspective and a Road Map for Research-Informed Practice. Journal of the Association for Information Systems, pp. 10351063. Web.

There are enough definitions of spirituality to realize that if this property is present in the personality, it permeates all its aspects. In a religious sense, spirituality is seen as the presence and action of the Holy Spirit in us, and through us and in the world, this is a specific divine-human state. As for the most general and accepted definition of spirituality, this refers to the highest level of development and self-regulation of a mature personality. At this level, the highest human values become the central motivational and semantic regulators of her life.

A spiritual person creates and represents a certain comfort for others. Integrity, intentionality is characteristic of the inner spiritual world, therefore the values and meaning of certain actions of such a persons personality are the best. A spiritual person cannot act against his conscience; therefore, it is not possible to expect bad things from a spiritual person. Patient-centered communication is an essential principle in the provision of medical care, regardless of whether the persons belief system is different from that of the doctor or not. (Murgia, 2020, p. 1332) In any case, the clinician needs to demonstrate understanding of the patients needs, acceptance, and respect, this will significantly reduce the level of anxiety initially.

In the provision of nursing palliative care, spirituality is vital in the two different senses mentioned above. In cases with the help and care of patients with cancer and HIV / AIDS, the nurse, her competence, spirituality play an essential role. It is she who has to spend most of the time with the patient, first providing him with help. She determines the patients various needs, is a link between him, the doctor, or relatives, independently determines the nature and amount of help, both moral and physical.

Reference

Murgia, C., Notarnicola, I., Rocco, G., & Stievano, A. (2020). Spirituality in nursing: a concept analysis. Nursing Ethics, 27(5), 1327-1343.

Introduction

The Doctor of Nursing Practice (DNP) basic qualifications include eight competencies. These basic competencies comprise a scientific basis for practice, systemic leadership, the use of analytics and information technology, health advocacy, prevention, and practice improvement (AACN, 2006). The current course is directly related to DNP essentials as it teaches how to achieve an evidence-based approach for effective future practice and promotes nurses as agents of change.

Discussion

During the course, strategies for research practice were explored, which will allow identifying the best treatment options. This experience is directly in line with DNP essentials and highlights the role of the nurse as a change leader in the team of medical professionals (Smith et al., 2018). Each nurse is a leader responsible for the overall approach and advocacy for patient well-being (Kouzes & Posner, 2012). The scientific basis for practice gained during the course will help use the accumulated knowledge to achieve the maximum level of effective care. The study of analytical methods contributes to the improvement of research skills, which is necessary for a DNP.

APRN plays an important role in the process of translating research into practice. Nurses are a driving force, using the best evidence-based theoretical approaches and acting for the benefit of patients (Melnyk & Fineout-Overholt, 2018). The data collected during the practice will help agree or refute the conclusions of the researchers. This practice is important because, regardless of the level of evidence, not all studies can be proven in practice. As the health care provider closest to the patient, APRN has the ability to collect the most reliable data. The transfer of new data to researchers will improve their work and consider new relevant approaches to treatment.

Conclusion

In conclusion, the current course is directly correlated with DNP essentials. The required skills and competencies are consistent with the research, analytical, and systematizing skills acquired during the course. This course promotes the special role of the nurse as a leader who can apply an evidence-based approach to improve the practice. Responsible collection and analysis of patient health data will contribute to future research into new effective treatment approaches.

References

American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. Web.

Kouzes, J., & Posner, B. (2012). The leadership challenge (5^th ed.). John Wiley & Sons, Incorporate.

Melnyk, B., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare (4^th ed.). Wolters Kluwer.

Smith, S., Hallowell, S. C., & Lloyd-Fitzgerald, J. (2018). AACNs DNP essential II prepares clinicians for academic leadership: Three DNP graduates share their leadership journey. Journal of professional nursing: official journal of the American Association of Colleges of Nursing, 34(1), 16-19. Web.

The nursing profession has come a long way of becoming, during which there were many difficulties and challenges for nurses of the past. However, overcoming these difficult periods of the formation of the profession led to what nurses do today. Nursing is one of the oldest professions, which means that this works evolutionary path has undergone many changes. Many significant changes have affected the way that profession is presented today.

The history of nursing began thanks to a turning point in history when women gained the right to care for the sick. This was made possible by the struggle of Florence Nightingale in the middle of the 19th century, which provided a new perspective on medicine (Pfettscher, 2021). This largely became the root cause of the future evolution of the nursing profession and provided a leap in the development of this branch of medicine. During this time, many of the founding statutes of nursing began to develop, giving birth to the profession. Thus, we can say that Nightingale is the one thanks to which nursing exists today.

The history of the development of nursing has brought this work into a separate profession with sufficient potential to become on par with the medical profession. Therefore, the functions of a nurse are much broader than simply following the instructions and prescriptions of a doctor. They have the primary responsibilities of patient care, disease prevention, health promotion, rehabilitation and relief of suffering. They must be a good leader who owns the makings of a leader, manager, teacher and psychologist. All these factors may, in the future, affect how the profession will develop and determine its direction. This may be, first of all, expanding the powers of nurses and entrusting them with more work than in the past and now.

Simultaneously with positive changes in medicine, the danger to which a person is exposed, falling into the sphere of medical influence, is increasing. With the rapid growth of the population and the spread of poverty among the inhabitants of our planet, the principles of providing medical care remain relevant: efficiency  equality  safety. This is another reason for the high demands placed on the nursing profession. Thus, the mission of nursing is to meet the needs of patients in highly qualified and specialized medical care. These are the main vectors for developing the profession that will be preserved in the future.

Indeed, the history of the formation of nursing is largely due to the personalities of the great innovators of nurses who tried to bring something new. Thanks to them, nursing has become more focused on the person or group of people than on the disease. Thus, it became a separate branch of medicine focused on the care and care of the sick, not specifically on the disease. It is aimed at solving the problems and needs of people, their families and society as a whole, which have arisen or may arise in connection with changes in health.

In the future, a big change in the profession is possible as advances in medicine and technology constantly provide the world with new inventions. For example, many devices can monitor a patients condition, such as a pulse and transmit it to a nurse via wireless communication. A few decades ago, humanity could not imagine the emergence of such technologies. The future of this profession may be subject to significant changes due to influences from the past, as some of the research was started long before it could be used. However, every year, development and research brings many methods by which the work of nurses is transformed and facilitated.

Reference

Pfettscher, S. A. (2021). Florence Nightingale: modern nursing. Nursing Theorists and Their Work E-Book, 52.

Introduction

A 52-year-old patient visited the emergency department of a hospital complaining of blurred vision and numbness in their hand. They were diagnosed by Nurse A with a transient ischemic attack and their symptoms quickly resolved (Nurse Case Study, n.d.,). However, a later examination by another nurse, B, revealed slurred speech, confusion, and weakness on the right side. These symptoms were reported to the emergency department and the doctor was contacted, but the neurologist did not examine the patient for over an hour. By that time, it was too late to administer tPA, a treatment for stroke. The patients symptoms worsened, and they were eventually diagnosed with a full stroke. As a result, they experienced partial paralysis of their arm, aphasia, mild cognitive impairment, and foot drop.

The patient filed a lawsuit alleging negligence on the part of the hospital staff for failing to timely diagnose and treat the stroke. The plaintiff argued that the stroke was caused by a clot that traveled to the brain and could have been treated with tPA. The hospital staff argued that tPA would not have been beneficial and that the stroke was caused by a circulatory obstruction due to a dissection of the left internal carotid artery. The case was settled for $4 million at the end of the plaintiffs presentation of evidence at trial.

Impact of Legal Issue

This legal case highlights the importance of timely and accurate diagnosis and treatment in nursing practice. Nurses have a duty to provide competent care to their patients and to follow established protocols and standards of practice. In this case, the failure to diagnose and treat the patients stroke had serious consequences for the patient, including partial paralysis, aphasia, and cognitive impairment. This case also emphasizes the importance of thorough and accurate communication among healthcare professionals. There was a discrepancy between the initial examination of the patient by the doctor and nurse A and the later examination by nurse B. This miscommunication may have contributed to the delay in diagnosis and treatment.

Regulations, Laws, and Standards and Their Impact

There are several regulations, laws, and standards that pertain to the issue of timely and accurate diagnosis and treatment in healthcare, including:

1. The Standard of Care: This refers to the level of care that a reasonably competent and skilled healthcare professional would provide under similar circumstances (Hoskins et al., 2018). If a healthcare professional fails to meet the standard of care, they may be found negligent in a legal action.
2. Medical Negligence: Medical negligence occurs when a healthcare professional fails to provide care that meets the standard of care and as a result, a patient is harmed (Ozaras and Abaan, 2018). Nurses may be held liable for medical negligence if they fail to competently diagnose and treat a patients condition.
3. HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of patients personal and medical information (Ozaras and Abaan, 2018). HIPAA requires healthcare professionals to maintain the confidentiality of this information and to only share it with authorized individuals.
4. State Nursing Practice Acts: Each state has its own Nursing Practice Act, which outlines the scope of practice for nurses in that state and sets forth the standards that nurses must follow in their practice. These acts may include provisions related to the diagnosis and treatment of patients.

The impact of these regulations, laws, and standards is to ensure that healthcare professionals provide competent and appropriate care to their patients and to protect the privacy and confidentiality of patients personal and medical information. If these regulations, laws, and standards are not followed, healthcare professionals may face legal consequences and may damage the trust of their patients.

Risk-Mitigation Techniques

There are several risk-mitigation techniques that nurses can use to help prevent legal issues related to the timely and accurate diagnosis and treatment of patients. One important technique is to obtain informed consent from patients before providing any treatment or procedures. This involves fully explaining the risks, benefits, and alternatives to the patient and ensuring that the patient understands their options before proceeding. By obtaining informed consent, nurses can help to ensure that patients are fully informed about their care and can make informed decisions about their treatment.

Another important technique is to follow established protocols and standards of practice for diagnosing and treating patients. This includes following evidence-based guidelines and seeking guidance from more experienced colleagues when needed (Heinen et al., 2019). By following established protocols and standards, nurses can help to ensure that they are providing competent and appropriate care to their patients. Effective communication is also crucial in mitigating legal risks in nursing practice. Nurses should ensure that they communicate effectively with other members of the healthcare team and share all relevant information about a patients condition. This includes accurately documenting observations and reporting any changes in the patients condition to the appropriate healthcare provider.

Conclusion

There are several actions that nurses can take to increase compliance with these regulations, laws, and standards. One action that nurses can take is to stay informed about current guidelines and best practices for diagnosing and treating patients. This includes reading professional literature and attending continuing education courses. By staying up to date on the latest developments in their field, nurses can ensure that they are providing care that meets current standards and guidelines (Ozaras and Abaan, 2018). Nurses also should fully explain the risks, benefits, and alternatives to the patient and ensure that the patient understands their options before proceeding. By obtaining informed consent, nurses can help patients to be informed about their care and make decisions regarding their treatment.

References

Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378-2392.

Hoskins, K., Grady, C., & Ulrich, C. M. (2018). Ethics education in nursing: Instruction for future generations of nurses. OJIN: The Online Journal of Issues in Nursing, 23(1), 1-4.

Nurse Case Study: Failure to timely diagnose and treat stroke. (n.d.). NSO. Web.

Ozaras, G., & Abaan, S. (2018). Investigation of the trust status of the nursepatient relationship. Nursing Ethics, 25(5), 628-639. Web.